Assessment of Virtual Touch Tissue Imaging Quantification and the Ultrasound Thyroid Imaging Reporting and Data System in Patients With Thyroid Nodules Referred for Biopsy

Mao, Feng; Xu, Hui‐Xiong; Zhou, Huaqiang; Bo, Xiao-Wan; Li, Xiaolong; Li, Dandan; Liu, Bo-Ji; Zhang, Yifeng; Xu, Junmei; Qu, Shen

doi:10.1002/jum.14413

Cited by 14 publications

(10 citation statements)

References 42 publications

(92 reference statements)

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“…The main disadvantage of all RSSs is that they focus on recommending FNA for TNs ( 1 , 2 , 5 , 21 ), which leads to unnecessary FNA. Ultrasound elastography has been reported to be helpful in the diagnosis of benign and malignant TNs ( 12 , 13 , 32 , 33 , 34 , 35 , 36 , 37 ). When all TNs were reclassified according to perinodular stiffness combined with the RSSs, 11 KWAK-4a TNs were redefined as grade 3 TNs, 17 ACR TR4 TNs were redefined as TR3 TNs, 16 EU-TIRADS intermediate suspicion TNs were redefined as low suspicion, and 32 C-TR4A TNs were redefined as C-TR3 TNs in our study ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

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Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

Liu

Pei

et al. 2021

Endocrine Connections

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Objective: We evaluated the diagnostic accuracy of perinodular stiffness, four risk stratification systems (RSSs) (KWAK-TIRADS, ACR-TIRADS, EU-TIRADS, and C-TIRADS), and the combination of perinodular stiffness and these four RSSs in differentiating malignant from benign thyroid nodules (TNs). Methods: A total of 788 TNs in 726 patients were examined with conventional ultrasound (US) examination and sound touch elastography (STE). All TNs were classified by each of the four RSSs. The stiffness inside (E) the TNs was measured by STE. The stiffness of the 2.0mm perinodular region (Eshell) was measured with the Shell measurement function of STE. The diagnostic performances of four RSSs, the E values, and the Eshell values were evaluated. All TNs were further divided into subgroups based on size (≤ 10 mm group and > 10 mm group). Results: Ninety-six TNs were classified as benign and 692 as malignant. Among the single-method approaches, ACR-TIRADS showed the highest AUC (0.77) for differentiating malignant from benign TNs for all TNs included. Eshell showed the highest AUC (0.75) in differentiating malignant from benign TNs for TNs with sizes ≤ 10 mm, and there were no significant differences in AUC among all single methods for diagnosis of TNs with sizes > 10 mm (P > 0.05). The combination of C-TIRADS and Eshell/E yielded the highest AUC for all TNs (0.83) and for TNs with size ≤ 10 mm (0.85) compared with other combinations. Conclusions: Eshell/E combined with conventional US improves the diagnostic accuracy in TNs, and may reduce unnecessary fine needle aspiration.

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Section: Discussionmentioning

confidence: 99%

“…Ultrasound elastography (UE) has been shown to improve differentiation between benign and malignant TNs ( 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ). Sound touch elastography (STE) and the Shell measurement function enable the quantitative assessment of interior and perinodular stiffness of a TN.…”

Section: Introductionmentioning

confidence: 99%

Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

Liu

Pei

et al. 2021

Endocrine Connections

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“…A SW-quality map is available to evaluate whether SWS propagation is reliable or adequate (Fig. 10) [23,24].…”

Section: Principles Of Us Elastography Techniques In the Thyroidmentioning

confidence: 99%

“…The technology is still under development, and to gain widespread clinical application, further validation will be necessary, with large cohort and multi-center prospective studies with less pre-selection to evaluate different TN characteristics, uncommon pathologies, and reproducibility, with the ultimate goal of determining how US elastography can be integrated with conventional US into emerging malignant risk classification systems (e.g., TI-RADS). Moreover, standardization of US elastography techniques will be necessary [24,102].…”

Section: Summary and Future Directionsmentioning

confidence: 99%

Ultrasound elastography of the thyroid: principles and current status

Zhao

2019

Ultrasonography

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Ultrasound (US) elastography has been introduced as a non-invasive technique for evaluating thyroid diseases. This paper presents a detailed description of the technical principles, peculiarities, and limitations of US elastography techniques, including strain elastography and shear-wave elastography. This review was conducted from a clinical perspective, and aimed to assess the usefulness of US elastography for thyroid diseases in specific clinical scenarios. Although its main focus is on thyroid nodules, the applications of US elastography for other thyroid diseases, such as diffuse thyroid diseases and thyroiditis, are also presented. Furthermore, unresolved questions and directions for future research are also discussed.

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“…When the stiffness distribution of lesion was heterogeneous, 2 SWV boxes were placed on the softest and hardest areas, respectively, and the other 3 region‐of‐interest boxes were randomly placed in the remaining positions. Thereafter the maximal and mean SWS values were used for the final analysis 16,17 …”

Section: Methodsmentioning

confidence: 99%

Reducing Unnecessary Biopsy of American College of Radiology Thyroid Imaging Reporting and Data System Category 4 Nodules

Zhou

et al. 2020

J of Ultrasound Medicine

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Objectives To assess the effectiveness of strain elastography (SE), Virtual Touch tissue imaging and quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) and their combination (SE + VTIQ) in distinguishing benign from malignant American College of Radiology Thyroid Imaging Reporting and Data System category 4 nodules (TR4) to reduce unnecessary biopsy. Methods In this retrospective study, 985 thyroid nodules from 920 patients were initially enrolled and examined with conventional ultrasound, SE, and VTIQ. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SE, VTIQ, and SE + VTIQ were calculated respectively. An area under the receiver operating characteristic curve analysis was applied to evaluate the diagnostic efficiency of SE, VTIQ, and SE + VTIQ in the differentiation of benign and malignant TR4 nodules. Results A total of 864 patients with 922 TR4 nodules were enrolled ultimately, as 63 thyroid nodules from 56 patients were excluded because they did not meet the inclusion criteria of this study. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SE, VTIQ, and SE + VTIQ were 72.4% versus 86.3% versus 82.1%, 77.7% versus 80.5% versus 83.5%, 70.6% versus 76.1% versus 80.2%, 73.4% versus 76.3% versus 83.5%, and 75.5% versus 79.7% versus 82.8%, respectively. The areas under the receiver operating characteristic curve for the diagnosis of TR4 nodules by SE, VTIQ, and SE + VTIQ were 0.751, 0.817, and 0.844. Conclusions In spite of a slight decrease in the sensitivity, the application of combining SE and VTIQ techniques can improve the specificity and accuracy of TR4 nodule diagnosis, which can help reduce unnecessary biopsies of TR4 nodules.

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Assessment of Virtual Touch Tissue Imaging Quantification and the Ultrasound Thyroid Imaging Reporting and Data System in Patients With Thyroid Nodules Referred for Biopsy

Abstract: The additional application of VTIQ can improve the specificity of the TI-RADS for evaluating thyroid nodules without a loss of sensitivity.

Cited by 14 publications

References 42 publications

Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

Ultrasound elastography of the thyroid: principles and current status

Reducing Unnecessary Biopsy of American College of Radiology Thyroid Imaging Reporting and Data System Category 4 Nodules

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